What is Known about the Career Outcomes of UK Undergraduate and Graduate Medical Students: a Scoping Review
Emma Andrews | University of Warwick
Virtual Reality (VR) provides users with a realistic, 3D experience that allows surgical trainees to practice skills in a safe environment. The field of Trauma and Orthopaedics (T&O) is yet to utilize VR in training, despite its advantages as a teaching aid. This study aims to conduct a systematic review to investigate the efficacy of VR in T&O training, against current simulation methods.
To outline the landscape of the current research a scoping review was conducted, using the framework proposed by Arksey and O’Malley 2005. After duplicates were removed 5311 papers, from Medline, Web of Science and Education Research Complete, were screened by abstract and title. 55 papers were selected to screen based on full text, and 6 papers were chosen for inclusion in the review.
Doctors from graduate entry programmes are more likely to enter directly into training than those on standard entry programmes, but are no more likely to enter GP training. Graduates from standard entry programmes, however, are more likely to enter GP training. Looking at specialty choice in general, graduates on both standard and graduate entry programmes are more likely to pick higher earning specialties.
Those on graduate entry programmes have the same ambitions as undergraduates but are more confident in them. Moving directly into specialty training may be motivated by external responsibilities, but these additional responsibilities do not cause those on GEPs to choose more ‘family friendly’ specialties such as GP.
What is the Effect of a Peer-Teaching Programme at Medical School on Student Performance? A Systematic Review and Meta-Analysis
Clarissa Brierley | University of Warwick
The practice of peer-assisted learning (PAL) at medical schools alongside the core medical curriculum has increased steadily in recent years. While it has been suggested that the learning environment peer-tutors and their students share allows concepts to be presented at the correct level, the efficacy of PAL relative to traditional teaching methods is not clearly defined.
A systematic review of randomised studies of PAL conducted in medical school was completed. A literature search was conducted in four databases and records were selected following strict eligibility criteria. Following full text assessment, two reviewers independently extracted data. The impact size of the study outcomes was assessed using a modified version of “Kirkpatrick’s Levels of Learning”. Student test scores were standardised by calculating the standardised mean difference (SMD).
25 randomised controlled trials were included in this review. Meta-analysis of 19 articles identified a significant improvement in the academic performance of medical students who received PAL compared to those in the control group (SMD = 0.43 [95% confidence interval 0.07 – 0.80]; p=0.02). The impact of PAL was more marked amongst clinical than pre-clinical medical students, and when used for teaching practical skills compared to theory. PAL was also more effective than non-PAL methods in assessments run more than four weeks after course completion.
Medical students taught using PAL derive objective benefit in terms of academic performance, relative to non-PAL teaching methods. PAL is of particular value in the clinical stages of training. The long-term outcomes of PAL remain understudied.
Medical Specialties that Interest Students and Why
Lauren Grahame | Swansea University
Whilst at university medical students have the opportunity to spend time in different specialities, however this may only be for a day or two, or in the case of more niche specialities, not at all. Without the exposure on placement, students may never know about the wide variety of career pathways available to them.
A quick sell event was set up where clinicians can speak for 2 minutes about their chosen speciality and why students should be interested, with an informal networking event for the students to ask any questions afterwards. Interests in different specialities will be measured before and after the event with via questionnaires. Due to the Covid-19 outbreak the event had to be cancelled, instead a survey was sent out to the students to gather information on what specialities the students were interested in and what helped them decide their career route. The results of this survey can then hopefully be used to create more successful career events in the future.
Emergency medicine and Medical Specialities were the most popular specialities
The biggest difference between genders is their interest in Medical Specialities
Majority of students are currently interested in 4 different specialities
No significant difference in age groups and specialities interested in
The major factor is deciding future careers is if it suits a student’s personality
The specialities introduced to students earlier on throughout their university career seem to be the most influential on helping them make career choices.
ScotGEM Stories: Sharing Student Experiences
Andrew MacFarlane | The Universities of St. Andrews & Dundee (ScotGEM)
The novel Scottish Graduate Entry Medicine (ScotGEM) course had the first intake of students in 2018/19 and is delivered in partnership between the Universities of St Andrews and Dundee. The ScotGEM Stories website was launched by students to publish their reflections and share their experiences. In ScotGEM, students undertake much of their medical education in remote and rural Scotland with the aim to boost future recruitment to these areas.
The ScotGEM Stories website is delivered via WordPress with oversight from Student Editors and Staff Reviewers. The website was launched in December 2019 with various social media outlets linked later.
The website has had 6,480 views since launch with 29 posts and 33 hours of watch time on YouTube, sharing the experiences of students and staff involved in the delivery of the course.
There was an appetite amongst the cohort to have an outlet to reflect on their experiences and express themselves. There is also a desire from ScotGEM students - many having taken the long route to studying medicine - to motivate and enthuse potential prospective students to take a similar leap by exploring deeply some of the experiences that have reaffirmed their decision to study medicine. There is a shared value in promoting positive experiences from students and staff that both groups perhaps do not fully realise or experience first-hand. Rural Scotland provides a venue for medical students to realise the doctors they aspire to become - and ScotGEM Stories aims to share their journey.
The Use of Simulation in Medical Student Education on the Topic of Breaking Bad News
Thomas Dale MacLaine & Nicholas Lowe | University of Warwick
Breaking Bad News (BBN) is a critical skill for doctors when disclosing life-changing information with patients. Simulated patients (SPs) are widely used to develop communication skills, though the best method to engage them in undergraduate BBN medical education is unclear.
We searched 14 databases with the search terms “Medical education”, “Patient simulation”, “Bad news”. Two independent blinded reviewers screened articles by title and abstract, followed by full text review. Full texts were checked for quality and bias, before their inclusion into the review. Data was systematically extracted and thematic analysis was used to identify themes and subthemes within the selected articles.
Out of the 2117 articles screened, 29 publications met the inclusion criteria. Studies investigate a variety of simulated patient models, including actors as patients (65.5%), peers (7.0%), and cancer survivors (3.5%). Several models exist for training BBN, which is done at varying times in undergraduate medical training. Students report needing additional guidance with BBN between training and clinical exposure. Our thematic analysis centres around two overarching themes: intrinsic components of BBN, and the validation of models used in BBN consultations.
SPs are beneficial for training BBN, allowing students to practice vital communication skills without detriment to patient care. Students may benefit from top-up training or support when using BBN skills in practice. Several models used to deliver BBN training are published, with limited literature comparing effectiveness.
Evaluating the Efficacy of a Novel, Zero-Cost Training Day for Widening Participation in Medicine
Andrew Gadie, Oliver Burton | University of Warwick
Simulated MMI events are frequently cited as essential preparation for entry into medical school, but often represent a barrier to students owing to cost and availability.
A student collective created a zero-cost WP (Widening Participation) MMI Workshop & 6 station circuit and evaluated its effectiveness across participants from a variety of socioeconomic backgrounds across a two-year period.
A standardised MMI circuit was devised, along with workshops on interview techniques and a careers talk. Participants were recruited from local schools identified by the University of Warwick as having lower than average throughput into medicine ((2018 (n = 58), 2019 (n = 38)).
Pre and Post Intervention ratings across 6 different domains (e.g. Confidence, Understanding, etc) were collected by questionnaire, alongside participant demographics.
In both years, all candidates demonstrated significant improvement across all domains indicating that this was an effective intervention.
Candidates meeting more WP criteria reported significantly more improvement across multiple domains in both years, compared to their non-WP peers. No significant variation in candidate’s improvement was found when comparing candidates self-reported ethnicity.
All participants reported that the Outreach programme has improved their performance, and better prepared them for an interview.
This was a resource intensive programme, requiring both financial investment from external bodies and significant numbers of student volunteers.
The Medical Schools Council recommended in “Selecting for Excellence” that Medical schools need to improve candidates’ access to Outreach programmes and this novel initiative can be delivered regionally in conjunction with local schools.
Further study is required into the difference in effectiveness of the Outreach programme for WP candidates